Ewing sarcoma metastatic to the iris.

Purpose: To report a case of Ewing sarcoma metastatic to the iris.

Methods: A 19-year-old woman with metastatic Ewing sarcoma of the femur developed a diffuse, fluffy iris mass with a pseudohypopyon in the left eye. A fine-needle aspiration biopsy confirmed iris metastasis, and external beam radiotherapy was given to the affected eye.

Results: The iris mass responded initially to external beam radiotherapy and ongoing chemotherapy with vincristine, cyclophosphamide, doxorubicin, etoposide, and ifosfamide but recurred 5 months later. Subsequent radiotherapy with an iodine 125 plaque achieved further resolution of the iris tumor.

Conclusions: Ewing sarcoma can rarely metastasize to the iris. The diagnosis can be confirmed by fine-needle aspiration biopsy. Plaque radiotherapy is a therapeutic alternative.